|
SUTURE SHUTTLE STR CRESCENT
|
Facility
|
OP
|
$1,175.00
|
|
| Hospital Charge Code |
270672270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.37 |
| Max. Negotiated Rate |
$587.50 |
| Rate for Payer: Aetna Commercial |
$446.50
|
| Rate for Payer: Aetna Medicare Advantage |
$352.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$299.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$299.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$299.62
|
| Rate for Payer: Cigna Commercial |
$587.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$305.50
|
| Rate for Payer: Oxford Commercial |
$235.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$176.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$37.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.37
|
|
|
SUTURE SILK 0 CT-1/GS-1
|
Facility
|
IP
|
$10.60
|
|
| Hospital Charge Code |
270655640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$1.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.59
|
|
|
SUTURE SILK 0 CT-1/GS-1
|
Facility
|
OP
|
$10.60
|
|
| Hospital Charge Code |
270655640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$5.30 |
| Rate for Payer: Aetna Commercial |
$4.03
|
| Rate for Payer: Aetna Medicare Advantage |
$3.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.70
|
| Rate for Payer: Cigna Commercial |
$5.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.76
|
| Rate for Payer: Oxford Commercial |
$2.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.30
|
|
|
SUTURE SILK 0 FSL C-16
|
Facility
|
OP
|
$8.73
|
|
| Hospital Charge Code |
270655819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$4.37 |
| Rate for Payer: Aetna Commercial |
$3.32
|
| Rate for Payer: Aetna Medicare Advantage |
$2.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.23
|
| Rate for Payer: Cigna Commercial |
$4.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.27
|
| Rate for Payer: Oxford Commercial |
$1.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.25
|
|
|
SUTURE SILK 0 FSL C-16
|
Facility
|
IP
|
$8.73
|
|
| Hospital Charge Code |
270655819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.31 |
| Max. Negotiated Rate |
$1.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.31
|
|
|
SUTURE SILK 0 KS
|
Facility
|
IP
|
$7.18
|
|
| Hospital Charge Code |
270660196
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$1.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.08
|
|
|
SUTURE SILK 0 KS
|
Facility
|
OP
|
$7.18
|
|
| Hospital Charge Code |
270660196
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$3.59 |
| Rate for Payer: Aetna Commercial |
$2.73
|
| Rate for Payer: Aetna Medicare Advantage |
$2.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.83
|
| Rate for Payer: Cigna Commercial |
$3.59
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.87
|
| Rate for Payer: Oxford Commercial |
$1.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.44
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.20
|
|
|
SUTURE SILK 0 PSL
|
Facility
|
IP
|
$18.27
|
|
| Hospital Charge Code |
270672373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$2.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.74
|
|
|
SUTURE SILK 0 PSL
|
Facility
|
OP
|
$18.27
|
|
| Hospital Charge Code |
270672373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$9.13 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare Advantage |
$5.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.66
|
| Rate for Payer: Cigna Commercial |
$9.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.75
|
| Rate for Payer: Oxford Commercial |
$3.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.52
|
|
|
SUTURE SILK 0 TIES
|
Facility
|
IP
|
$6.55
|
|
| Hospital Charge Code |
270671434
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$0.98 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.98
|
|
|
SUTURE SILK 0 TIES
|
Facility
|
OP
|
$6.55
|
|
| Hospital Charge Code |
270671434
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$3.27 |
| Rate for Payer: Aetna Commercial |
$2.49
|
| Rate for Payer: Aetna Medicare Advantage |
$1.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.67
|
| Rate for Payer: Cigna Commercial |
$3.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.70
|
| Rate for Payer: Oxford Commercial |
$1.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.98
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.31
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.19
|
|
|
SUTURE SILK 0 TIES
|
Facility
|
IP
|
$11.03
|
|
| Hospital Charge Code |
270671501
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$1.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.65
|
|
|
SUTURE SILK 0 TIES
|
Facility
|
OP
|
$11.03
|
|
| Hospital Charge Code |
270671501
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$5.51 |
| Rate for Payer: Aetna Commercial |
$4.19
|
| Rate for Payer: Aetna Medicare Advantage |
$3.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.81
|
| Rate for Payer: Cigna Commercial |
$5.51
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.87
|
| Rate for Payer: Oxford Commercial |
$2.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.21
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.31
|
|
|
SUTURE SILK 0 V-20
|
Facility
|
OP
|
$5.95
|
|
| Hospital Charge Code |
270655849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$2.98 |
| Rate for Payer: Aetna Commercial |
$2.26
|
| Rate for Payer: Aetna Medicare Advantage |
$1.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.52
|
| Rate for Payer: Cigna Commercial |
$2.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.55
|
| Rate for Payer: Oxford Commercial |
$1.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.19
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.17
|
|
|
SUTURE SILK 0 V-20
|
Facility
|
IP
|
$5.95
|
|
| Hospital Charge Code |
270655849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$0.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.89
|
|
|
SUTURE SILK 1 TIES
|
Facility
|
IP
|
$6.50
|
|
| Hospital Charge Code |
270671435
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$0.98 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.98
|
|
|
SUTURE SILK 1 TIES
|
Facility
|
OP
|
$6.50
|
|
| Hospital Charge Code |
270671435
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Aetna Commercial |
$2.47
|
| Rate for Payer: Aetna Medicare Advantage |
$1.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.66
|
| Rate for Payer: Cigna Commercial |
$3.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.69
|
| Rate for Payer: Oxford Commercial |
$1.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.98
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.18
|
|
|
SUTURE SILK 1 V-20
|
Facility
|
OP
|
$8.06
|
|
| Hospital Charge Code |
270671493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$4.03 |
| Rate for Payer: Aetna Commercial |
$3.06
|
| Rate for Payer: Aetna Medicare Advantage |
$2.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.06
|
| Rate for Payer: Cigna Commercial |
$4.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.10
|
| Rate for Payer: Oxford Commercial |
$1.61
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.61
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
SUTURE SILK 1 V-20
|
Facility
|
IP
|
$8.06
|
|
| Hospital Charge Code |
270671493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$1.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.21
|
|
|
SUTURE SILK 2-0 FS C-15
|
Facility
|
OP
|
$13.14
|
|
| Hospital Charge Code |
270662582
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.37 |
| Max. Negotiated Rate |
$6.57 |
| Rate for Payer: Aetna Commercial |
$4.99
|
| Rate for Payer: Aetna Medicare Advantage |
$3.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.35
|
| Rate for Payer: Cigna Commercial |
$6.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.42
|
| Rate for Payer: Oxford Commercial |
$2.63
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.63
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.37
|
|
|
SUTURE SILK 2-0 FS C-15
|
Facility
|
IP
|
$13.14
|
|
| Hospital Charge Code |
270662582
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$1.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.97
|
|
|
SUTURE SILK 2-0 FSL C-16
|
Facility
|
OP
|
$8.73
|
|
| Hospital Charge Code |
270671394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$4.37 |
| Rate for Payer: Aetna Commercial |
$3.32
|
| Rate for Payer: Aetna Medicare Advantage |
$2.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.23
|
| Rate for Payer: Cigna Commercial |
$4.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.27
|
| Rate for Payer: Oxford Commercial |
$1.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.25
|
|
|
SUTURE SILK 2-0 FSL C-16
|
Facility
|
IP
|
$8.73
|
|
| Hospital Charge Code |
270671394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.31 |
| Max. Negotiated Rate |
$1.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.31
|
|
|
SUTURE SILK 2-0 KS
|
Facility
|
OP
|
$7.03
|
|
| Hospital Charge Code |
270600770
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$3.52 |
| Rate for Payer: Aetna Commercial |
$2.67
|
| Rate for Payer: Aetna Medicare Advantage |
$2.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.79
|
| Rate for Payer: Cigna Commercial |
$3.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.83
|
| Rate for Payer: Oxford Commercial |
$1.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.41
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.20
|
|
|
SUTURE SILK 2-0 KS
|
Facility
|
IP
|
$7.03
|
|
| Hospital Charge Code |
270600770
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$1.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.05
|
|